Laser for harvesting of the internal mammary artery

In 12 piglets both internal mammary arteries were dissected from the thoracic wall without a surrounding pedicle, using low-current electrocautery for one artery and continuous wave contact Nd:YAG laser (12 W) for the contralateral vessel. Changes in the arterial flow surface were evaluated by scanning electron microscopy immediately after dissection and 2 and 5 days postoperatively. Laser dissection was easier, more accurate and as fast as electrocautery. Moderate to severe degenerative changes and endothelial desquamation were seen in the electrocautery group after dissection, but lesser changes in the laser group. The changes decreased within the next 5 days, but two electrocauterized vessels showed thrombosis at 5 days. Stripping of the internal mammary artery with either method requires great care, and Nd:YAG laser offers a promising alternative to electrocautery in harvesting of that artery as a pedicled graft.